No, it's not a nautical term. It's a medicine used for retina problems. Monday (Feb 8) I had Avastin injected into my eye – and I have survived to tell about it! What follows is the gory details of the injection. If you do not like gory details just skip this post! But I am writing it for others who may someday need such an injection.
In early January I noticed an area of distortion in the upper left quadrant of one eye. At that point it was not in the macula and did not affect reading. But since I am very myopic I am at risk for retinal issues so went to see a local retina specialist.
I kept hoping the distortion in my right eye would get better with conservative treatment (anti inflammatory drops) but after a few weeks the area only got bigger. Once I decided to go for the anti-VEGF injection I went to the one and only doc in town who does it – and found out I’d have to wait another week because the Avastin would have to be ordered from the capital city. Although I wavered again and again over the next week, the area slowly got even bigger until I was totally unable to read a clock or calander or recognize faces with that eye . Reading a computer screen was slow and difficult even with enlargement, it was like looking through dirty water at italic and other weird shapes with piecs of the letters missing. And of course it is my dominent eye so it keeps trying to take over. By the time Monday came I was ready, if not exactly looking forward to it. The doc had ordered eye drops to start 4 days before the injection and an extremely (excessively?) high power antibiotic (Levofloxacin). Seemed a bit of over kill and after googling Levofloxacin I’m sure my fingers and feet started feeling numb!
Day 1 On Monday after lunch I went and got in line. They took me first so no chance to ask anybody else how it went. I was gratified that they used good aseptic technique, anesthesia drops, betadine drops and a presumably sterile face cloth with only a hole for the eye. The doctor put on some kind of head gear as well (I couldn’t see well with no glasses.) I was told to look off to the upper left. I am very nearsighted and couldn’t see much in the dim lighting but found a piece of shadow I tried to focus on. They put a gizmo to hold the eyelids open and did some more touching of the eye, none of which was painful. The injection itself wasn’t very painful but I saw the swirling of the medicine go in and lost the shadow I was trying to fix my eye on. I’m afraid my eye moved a little as I ended up with a good sized blood clot on the white of my eye. They patched the eye and gave me a list of instructions – eye drops every 2 hours for a week while awake, an anti-glaucoma drug the rest of today and tomorrow. Continue with the antibiotic for 5 more days. no bending, strenuous exercise or activity, no lifting heavy things, avoid sunlight and dust, close eyes while bathing for next week, and come back tomorrow. (The needle was nowhere as big as the drawing shows and was inserted on the outer side not the top.)
Total cost was $760 which I paid in cash after it was done. (And that was the cheaper procedeure. Lucentis would have been over $2100!)
I felt okay but it was weird having an eye patched, you kind of lose distance perspective like stepping off curbs, reaching for things, etc. The eye was starting to ache by the time I got home but the anti-glaucoma pill really seemed to help. I ended up taking the patch off because what with wearing glasses over it my eyelids kept brushing it and it was annoying. I did find a piece of clean gauze in my cupboard to cover it that first night. I could see as well as before the procedure but the blood did look kind of gross and I had to wipe some clots away that ran down after I put eye drops in.
Day 2 went okay, still taking the anti glaucoma drug and high power antibotic and eye drops every 2 hours. When I went back the doc said to not get my face wet in the shower (now he tells me!) but just clean with a cloth and to wash my hair like in a beauty parlor, not bent forwards. Sigh! Do you know how many times in a day a person bends over? Especially a tall person in a short man’s country?? I mean, books off of shelves, getting clothes out of cupboards, pans out of lower cabinets, lower desk drawers. I even have to get on my hands and knees to plug my computer in! That’s not to mention feeding the cats, or picking up things I drop, making bed, etc. Good things my knees are still good as I get lots of deep knee bends in these days! My eyes seemed tired and so I rested in the afternoon and went to bed a little earlier than usual.
Day 3 no more anti glaucoma med and so far so good, no aching. I got my hair washed today with assistance. We did at the outside sink. It was a bit messy and I had to change clothes afterwards but it’s great to have clean hair. It could be my imagination but the distorted area seems slightly clearer, I can read enlarged fonts through it, in a way it’s like having my own private magnifying glass LOL! Though still distorted. Faces are still not recognizable but I can see that it is a face, it’s not just all grayed out. And I can now see the center dot on the Amsler grid. I’m to go back in 2 weeks.
Day 4. Woke up feeling better. The bloody eye feels less sore. The possibly imagined slight improvement is still there. Wondering about this antibiotic tho. Something is giving me a head ache and making me feel kind of buzz-headed and spacey. It’s hopeless to do serious work. The bloody eye is getting slightly yellow around the edges (I can’t see cuz that eye still has the gray spot in the middle of whatever I look at but Maret helped me take a picture of it.)
Day 5 Still have a slight head ache. Wondering if it’s ok to stop the Levofloxacin a couple days early? Vision in right eye is dimmer than left. Used to be the other way around. Letters are also bigger in the right than the left. It’s been that way a long time, long before this bleed started. I CAN read with the right eye – it’s still dim and distorted but I CAN read. Interesting that in passages colored with colored pencil I can’t see the color. Hmmm. But I CAN read it. My eyes don’t work together yet, though so I still feel like things are kind of out of focus. I am going out to a meeting today so we shall see how I do!
Day 14 Went back to the doc today. I feel like the vision has improved significantly, tho not as to what it was before all this started. The line of print I read in a book or the screen is straight and clear tho the line above bows upward and the line below bows downward. I guess the distance acuity isn’t quite as sharp as it was as tho since I am not able to read all the letters on the chart. This doc is Dr Brevity. He kind of grunts and says “It’s flat”. Wondering if that’s good or bad I asked what was flat. He said the macula is flat that it had been swollen last time he saw it. I guess that’s good! But then he greases up the eye with lidocaine gel and sticks his scope in it and grunts again. Then goes off and writes a note to the referring doc and says it’ll happen again. (!?) He sees a scar, a black spot. There’s lattice degeneration and atrophy at 6 o’clock. I can go back to the referring doc in 2 weeks and she can laser it. So I am befuddled. Is this something new again? Why are we suddenly talking about laser??? His brevity doesn't help.
I have spent a lot of time on the internet and don’t find much. It seems no one has definitive answers to my questions such as why did this happen? How can I prevent a recurrence? Is exercise okay or not okay and what kind is bad? Anything but contact sports? Or as one doc said, only slow gentle stuff like walking and Tai Chi? And what about heavy lifting - like heavy bags when travelling and hauling water and washing clothes by hand in the village and hauling stuff on a motorbike? Certainly the three docs I have seem so far all had different opinions as to what was even wrong, let alone how to treat it or what if anything I could do to avoid future problems. Sigh!
lack. It is located less than a kilometer from our place and it has been running almost constantly for the last 3 weeks. It is extremely noisy and even at this distance there is a low pitched background thrumming that kind of gives you a headache after awhile. In fact, one of our neighbors is out house hunting right now because he can't sleep. He says not only is it noisy but it shakes the ground and even using ear plugs and closing windows and using air conditioner don't help. So they are scouting out a neighborhood out past the airport.
